Anteromedial Meniscofemoral Ligament of the Anterior Horn of the Medial Meniscus: Clinical, MR and Arthroscopic Features : A Retrospective Analysis
ESSKA Academy. Kim Y. 05/09/18; 212750; P15-1092
Young-Mo Kim
Young-Mo Kim
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Abstract
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Objectives: To describe the clinical, arthroscopic, and MRI findings of knees with anomalous insertion of the anterior horn of the medial meniscus (AHMM) into the intercondylar notch via an anteromedial meniscofemoral ligament (AMMFL).

Methods: : 2503 arthroscopic knee surgeries performed from July 2003 to October 2016 were reviewed retrospectively to identify knees with the AMMFL.
Medical records, arthroscopic photographs, and MR images of identified cases were analyzed. Fifty patients with normal medial meniscus (MM) were selected as a control group. Meniscus width and extrusion were measured on MR images.

Results: Total 13 (0.52%) cases had an AMMFL with insertion at the intercondylar notch. All cases were diagnosed incidentally during arthroscopy. Knee pain characteristics were related to surgical pathology; Arthroscopic examination revealed the AMMFL as a band-like structure covering the anterior ACL. In all cases, the AHMM had no bony attachment to the tibia and on probing of the AHMM, increased mobility was observed. MM was significantly larger than the general MM size in 8 cases (61.5%).. Twelve knees (92.3%) had meniscus tears. On MRI, AMMFL appeared as a low-signal linear structure arising at the AHMM and coursing superiorly along the anterior ACL. The mean MM width was greater than control group at the mid-body (P = 0.030), anterior horn (P = 0.002), posterior horn (P = 0.001).

Conclusions: All AMMFL was found incidentally during arthroscopic surgery and the AMMFL was silent lesion. There was no significant meniscal extrusion although the AHMM has no bony attachment. This is because the AMMFL may act as an anchor of the AHMM. Therefore, the AMMFL should not always be removed. MM with AMMFL tended to be larger than typical MM and may be related to some degree of hypermobility, which raises the risk of meniscal tears

Keywords:
Knee, Medial meniscus, anteromedial meniscofemoral ligament
Objectives: To describe the clinical, arthroscopic, and MRI findings of knees with anomalous insertion of the anterior horn of the medial meniscus (AHMM) into the intercondylar notch via an anteromedial meniscofemoral ligament (AMMFL).

Methods: : 2503 arthroscopic knee surgeries performed from July 2003 to October 2016 were reviewed retrospectively to identify knees with the AMMFL.
Medical records, arthroscopic photographs, and MR images of identified cases were analyzed. Fifty patients with normal medial meniscus (MM) were selected as a control group. Meniscus width and extrusion were measured on MR images.

Results: Total 13 (0.52%) cases had an AMMFL with insertion at the intercondylar notch. All cases were diagnosed incidentally during arthroscopy. Knee pain characteristics were related to surgical pathology; Arthroscopic examination revealed the AMMFL as a band-like structure covering the anterior ACL. In all cases, the AHMM had no bony attachment to the tibia and on probing of the AHMM, increased mobility was observed. MM was significantly larger than the general MM size in 8 cases (61.5%).. Twelve knees (92.3%) had meniscus tears. On MRI, AMMFL appeared as a low-signal linear structure arising at the AHMM and coursing superiorly along the anterior ACL. The mean MM width was greater than control group at the mid-body (P = 0.030), anterior horn (P = 0.002), posterior horn (P = 0.001).

Conclusions: All AMMFL was found incidentally during arthroscopic surgery and the AMMFL was silent lesion. There was no significant meniscal extrusion although the AHMM has no bony attachment. This is because the AMMFL may act as an anchor of the AHMM. Therefore, the AMMFL should not always be removed. MM with AMMFL tended to be larger than typical MM and may be related to some degree of hypermobility, which raises the risk of meniscal tears

Keywords:
Knee, Medial meniscus, anteromedial meniscofemoral ligament
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